Alternative medicine use by Canadian ambulatory gastroenterology patients: secular trend or epidemic?

Abstract

To assess the prevalence and determinants of alternative medicine (AM) use in gastroenterology outpatients and those with inflammatory bowel disease (IBD). An 80-item questionnaire, addressing symptoms, general health, quality of life, and AM use, was administered and analyzed using logistic regression. 52.5% of 341 participants used AM in the previous year. Most commonly used were herbal medicine (45.2% of users; 95% CI 35.4-52.5%), chiropractor (40.7%; 95% Cl 31.4-48.0%), and massage therapy (22.9%; 95% CI 15.9-29.1%). Reasons prompting AM use were ineffective medical therapy (39.5%; 95% CI 30.4-46.8%), a greater sense of self-control (29.1%; 95% CI 21.2-35.7%), agreement with personal beliefs (19.5%; 95% CI 13.1-25.4%), and conventional drug adverse-effects (17.3%; 95% CI 11.2-22.9%). AM use was predicted as follows: (1) higher education (odds ratio (OR) 2.10; 95% CI 1.22-3.60), (2) comorbid medical conditions (OR 1.80; 95% CI 1.08-3.00), 3) poor mental component summary score of the SF-12 health survey (OR 1.04; 95% CI 1.01-1.07), and (4) higher annual income (OR 1.17; 95% CI 1.001-1.36), but was not related to response to conventional medical therapy. AM practitioners had instructed 8.6% to change prescription medications. AM usage for gastrointestinal disease was greater in patients with IBD (44.6% vs 10.0%; p < 0.05), who were more likely to cite adverse drug effects as a reason for AM use (28.9 vs 14.4%; p = 0.03). AM was used by 52.5% of gastroenterology outpatients and its use was greater in those with a higher level of education, comorbid conditions, poorer mental health-related quality of life, and higher income. Drug-related side effects also led to increased AM use.